跳到主要內容

臺灣博碩士論文加值系統

(3.236.110.106) 您好!臺灣時間:2021/07/25 08:43
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

我願授權國圖
: 
twitterline
研究生:郭姿伶
研究生(外文):Kuo, Tzu-ling
論文名稱:探討癌症防治法對於女性子宮頸抹片篩檢推行的影響
論文名稱(外文):The Policy Impact of Cancer Prevention Act on Pap Smear Test diffusion.
指導教授:陳依兌陳依兌引用關係
指導教授(外文):Chen, Yi-Tui
口試委員:陳文典, 陳楚杰, 蘇慧芳, 謝碧晴
口試日期:2012-07-20
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:健康事業管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:中文
論文頁數:58
中文關鍵詞:擴散效果組織學習效果交互效果子宮頸抹片篩檢
外文關鍵詞:diffusion effectorganizational learning effectinteraction effectsPap smear screening
相關次數:
  • 被引用被引用:0
  • 點閱點閱:250
  • 評分評分:
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:1
背景:衛生署統計自1982年起,癌症便為國人十大死因之首位,為了減緩癌症對於國人健康的衝擊,衛生署於2003年實施癌症防治法,期望藉由宣導預防治療的觀念提升國人採取癌症篩檢的醫療服務,因此本研究探討癌症防治法實施後,台灣癌症篩檢的成效是否有所提升,並以子宮頸抹片檢查為例;同時分析影響子宮頸抹片篩檢的關鍵因素,藉此提供我國提升癌症篩檢率的政策建議,以降低癌症對於我國國民健康所造成的損害。
方法:本研究藉由擴散效果與組織學習效果之間的交互關係,並推導出交互效果模型,分析癌症防治法推行後,在社會網絡與衛生署之間的交互關係下,找出影響推行子宮頸癌篩檢的相關因素。
結論:本研究以擴散效果、組織學習效果與交互效果分析癌症防治法的推動對於子宮頸抹片篩檢行為的影響。研究結果指出子宮頸抹片篩檢的推行存在擴散效果,衛生署內部的具有組織學習效果;同時,當衛生署的組織學習效果發生時,組織內員工的績效將會增加,如此將有助於推動子宮頸抹片篩檢,進而加速子宮頸抹片篩檢的擴散速度。

Background: Since 1982, Department of Health indicates that cancer has become the first leading cause of mortality in Taiwan and also brings about a high impact on the public health. In order to reduce the impact, Department of Health enacts “Cancer Control Act” to improve the phenomenon of high mortality and incidence of cancer in 2003. One of the goals of Cancer Control Act is to encourage the public to adopt the Pap smear screening that may be helpful to detect the cervical cancer in the early stage. Therefore, this study analyzes whether the implementation of Cancer Control Act affects the adoption of Pap smear screening, and how the influence works.
Methods: As organizational learning effect takes place in Department of Health, employees may cumulate their ability and the promotion of Cancer Control Act performs well. And thus eventually Pap smear screening information spreads in the social network and provides a positive impact on diffusion effect. Through the analysis of this empirical study, the interaction effect is also identified.
Conclusion: In this study, we present a model by integrating diffusion effect, organizational learning effect and interaction effect to analyze the factors affecting the behavior of Pap smear screening. The results indicate that both diffusion effect and organizational learning effect exist significantly for the adoption of Pap smear screening.

目錄
中文摘要………………………………………………………………………I
英文摘要………………………………………………………………………II
目錄……………………………………………………………………………IV
表目錄…………………………………………………………………………V
圖目錄…………………………………………………………………………VI
第一章 緒論…………………………………………………………………1
第一節 研究背景與動機…………………………………………………1
第二節 問題陳述…………………………………………………………3
第三節 研究目的…………………………………………………………4
第四節 研究問題…………………………………………………………4
第五節 研究重要性………………………………………………………4
第二章 文獻探討……………………………………………………………6
第一節 健康促進與癌症預防發展………………………………………6
第二節 子宮頸抹片篩檢現況及子宮頸癌發生率與死亡率探討………9
第三節 子宮頸抹片篩檢之重要性………………………………………13
第四節 子宮頸癌篩檢可能影響因素……………………………………16
第五節 擴散效果、組織效果與交互效果模型…………………………20
第三章 研究方法……………………………………………………………25
第一節 研究設計…………………………………………………………25
第二節 研究對象…………………………………………………………26
第三節 研究資料來源及變項定義………………………………………27
第四節 資料處理與分析方法……………………………………………28
第四章 研究結果……………………………………………………………32
第一節 研究對象之描述性分析…………………………………………32
第二節 擴散效果模型分析………………………………………………36
第三節 組織學習效果模型分析…………………………………………38
第四節 交互效果模型分析………………………………………………40
第五章 討論及建議…………………………………………………………42
第一節 研究結論…………………………………………………………42
第二節 研究結果討論……………………………………………………43
第三節 研究優點與限制…………………………………………………45
第四節 應用與建議………………………………………………………45
參考文獻………………………………………………………………………46
中文部分……………………………………………………………………46
英文部分……………………………………………………………………50

表目錄
表1 歷年台灣女性子宮頸癌占所有癌症中發生率及死亡率………………11
表2 擴散效果…………………………………………………………………36
表3 學習效果…………………………………………………………………38
表4 交互效果…………………………………………………………………40

圖目錄
圖1 研究流程示意圖 ……………………………………………………… 26
圖2 1996年-2008年台灣三十歲以上女性人數 ……………………………32
圖3 1996年-2008年間參與免費子宮頸抹片篩檢行為之樣本數 …………33
圖4 1996年-2008年間參與免費子宮頸抹片篩檢行為之篩檢率 …………34
圖5 1996年-2008年平均每人每年醫療保健支出 …………………………35

中文部份
孔憲蘭(2011)‧海峽兩岸腫瘤學術會議:癌症防治-醫院的功能與角色‧台北市:台灣臨床腫瘤醫學會。
行政院研究發展考核委員會(2010,12月3日) ‧99年度由院管制「國家癌症防治四年計畫--癌症篩檢」查證報告‧檢索日期/瀏覽日期2012年2月12日,取自http://www.rdec.gov.tw/public/Attachment/121114492471.doc
行政院衛生署(2008,3月28日) ‧婦女健康政策‧檢索日期/瀏覽日期2012年3月18日,取自http://www.doh.gov.tw/CHT2006/DM/DM2_p01.aspx?class_no=112&now_fod_list_no=9391&level_no=2&doc_no=53212
行政院衛生署(2011,7月29日) ‧99年度死因統計‧檢索日期/瀏覽日期2012年3月5日,取自http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=11897&class_no=440&level_no=3
行政院衛生署(2012,1月5日) ‧民國99年國民醫療保健支出‧檢索日期/瀏覽日期2012年3月20日,取自http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=12040&level_no=2&doc_no=83068
行政院衛生署國民健康局(2011,12月22日) ‧癌症登記互動查詢系統台灣女性子宮頸癌每10萬人口標準化發生率‧檢索日期/瀏覽日期2012年3月1日,取自https://cris.bhp.doh.gov.tw/pagepub/AppReport.aspx?C=N11N4FFFFFFFF01N0001001N53N5602N4286674642E7765622E766965772E437251756572794E6F726D616C4157696E646F772C4170705765620603N4153C636D6451756572795F436C69636B3E625F5F32300904N41004N52N5A0605N42466656231653734372D386466362D343635352D383738622D3266373766376365653535660B
行政院衛生署國民健康局(2011,12月22日) ‧癌症登記互動查詢系統台灣女性子宮頸癌每10萬人口標準化死亡率‧檢索日期/瀏覽日期2012年3月1日,取自https://cris.bhp.doh.gov.tw/pagepub/AppReport.aspx?C=N11N4FFFFFFFF01N0001001N53N5602N4286674642E7765622E766965772E437251756572794E6F726D616C4157696E646F772C4170705765620603N4153C636D6451756572795F436C69636B3E625F5F32300904N41004N52N5A0605N42465366666636438662D343536382D346332332D386164352D3766613765653563376536320B
行政院衛生署國民健康局(2009,12月31日) ‧93-97年子宮頸抹片篩檢登記年報‧檢索日期/瀏覽日期2011年12月1日,取自http://www.bhp.doh.gov.tw/bhpnet/portal/StatisticsShow.aspx?No=201003110001
全國法規資料庫(無日期) ‧癌症防治法‧檢索日期/瀏覽日期2012年2月1日,取自http://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=L0070008
吳佳蓉(2008)‧衛生所子宮頸抹片篩檢策略應用與篩檢成果之相關性探討---以高雄縣市為例‧高雄醫學大學,高雄,台灣。
李翠鳳、郭旭崧、陳錫中、陳天順、周碧瑟(1997)‧金門縣婦女子宮頸防癌抹片檢查的影響因素‧中華公共衛生雜誌,16(3),198-210。
林幼平、郭旭崧、謝長堯、黃文哲、陳建仁(1996) ‧子宮頸癌篩檢工具之評估‧中華公共衛生雜誌,15(5),411-424。
林惠賢、王琳華、劉淑敏、康啟杰(2003)‧屏東地區婦女接受子宮頸抹片檢查之相關因素‧臺灣公共衛生雜誌,22(2),127-133。
徐瑋宏、郭平欣(2008)‧子宮頸抹片篩檢「認知」與「利用」的影響因素分析--雙元普羅比模型之實證研究‧臺灣公共衛生雜誌,27(3),232-242。
周碧瑟、賴明芸(1993)‧各國子宮頸癌篩檢計畫之初探‧公共衛生,19(4),384-392。
國家衛生研究院(2007)‧子宮頸癌篩檢臨床指引‧2012 年2 月14日取自http://www.nhri.org.tw/NHRI_ADM/userfiles/file/tcog/gog_a.pdf
黃月桂、葉明義、林勤豐(1998) ‧全民健康保險子宮頸抹片檢查之利用度研究‧中華衛誌,17(1),28-34。
陳慈怡、李嬿如、游山林、陳建仁、謝長堯、陳素秋(2005)‧全民健保實施前後影響子宮頸抹片篩檢之因素與成果‧臺灣衛誌,24(5),440-451。
陳錫中、周碧瑟(1995)‧台灣鄉村婦女對「子宮頸防癌抹片檢查」的認知及參與之調查研究‧中華衛誌,14(6),494-501。


American Cancer Society. (2012). Cancer prevention and early detection facts & figures 2012. Retrieved February 9, 2012, from http://www.cancer.org/Research/CancerFactsFigures/CancerPreventionEarlyDetectionFactsFigures/cancer-prevention-early-detection-2012
Andrae, B., Kemetli, L., Sparen, P., Silfverdal, L., Strander, B., Ryd, W., et al. (2008). Screening-preventable cervical cancer risks: Evidence from a nationwide audit in Sweden. Journal of the National Cancer Institute, 100(9), 622-629.
Anttila, A., & Ronco, G. (2009). Description of the national situation of cervical cancer screening in the member states of the European Union. European Journal of Cancer, 45, 2685-2708.
Agurto, I., Sandoval, J., Rosa, M. D. L., & Guardado, M. E. (2006). Improving cervical cancer prevention in a developing country. International Journal for Quality in Health Care, 18(2), 81-86.
Arbyn, M., Rebolj, M., De Kok, I. M., Fender, M., Becker, N., O’Reilly, M., et al. (2009). The challenges of organising cervical screening programmes in the 15 old member states of the European Union. European Journal of Cancer, 45, 2671-2678.
Argyris, C., & Schon, D. (1996). Organizational learning II: Theory, method and practice, Reading, Mass: Addison Wesley.
Bass, F. M. (1969). A new product growth model for consumer durable. Management Science, 15(5), 215-227.
Bayus, B.L. (1993). High-definition television: assessing demand forecasts for a next generation consumer durable. Management Science, 39 (11), 1319-1333.
Breitkopf, C. R., Pearson, H. C., & Breitkopf, D. M. (2005).Poor knowledge regarding the Pap test among low-income women undergoing routine screening. Perspectives on Sexual & Reproductive Health, 37(2), 78-84.
Byrd, T. L., Peterson, S. K., Chavez, R., & Heckert, A. (2004).Cervical cancer screening beliefs among young Hispanic women. Preventive Medicine, 38(2), 192-197.
Boyes, D. A., Nichols, T. M., Miller, A. M., & Worth, A. J. (1977). Recent results from the British Columbia screening program for cervical cancer. American Journal Obstetric Gynecology, 128(7), 692-693.
Buckley, J. (2004). Duration dependence, functional form, and corrected standard errors: Improving EHA models of state policy diffusion. State Politics and Policy Quarterly, 4(1), 94-113.
Centers for Disease Control and Prevention. (2012). Cervical cancer screening. Retrieved February 28, 2012, from http://www.cdc.gov/cancer/cervical/basic_info/screening.htm
Chen, L. S., Huang, N., Tsay, J. H., Wang, P. J., Chou, Y. J., Chou, P., et al. (2007). Screening for cervical cancer among female physicians and their relatives in Taiwan: A population-based comparative study. Preventive Medicine, 44, 531-535.
Chen, Y. T., & Chang, D. S. (2010). Diffusion effect and learning effect: an examination on MSW recycling. Journal of Cleaner Production, 18(5), 496-503.
Chen, Y. Y., You, S.L., Chen, C. A., Shih, L. Y., Koong, S. L., Chao, K. Y., et al. (2009). Effectiveness of national cervical cancer screening programme in Taiwan. British Journal of Cancer, 101, 174-177.
Chen, K. H., Huang, Y. J., & Yang, C. H. (2009). Analysis of regional productivity growth in China: A generalized metafrontier MPI approach. China Economic Review , 20, 777-792.
Chiang, C. J., Chen, Y. C., Chen, C. J., You, S. L.,& Lai, M. S. (2010). Cancer trends in Taiwan. Japanese Journal of Clinical Oncology, 40(10), 897-904.
Chou, P., Chen, V. (1989). Mass screening for cervical cancer in Taiwan from 1974 to 1984 . Cancer, 64(4), 962-968.
Cohen, w. m., & Levinthal, D. A. (1990). A new perspective on learning and innovation. Administrative Science Quarterly, 35,128-152.
Coke, A. L., Desimone, C. P., Eggleston, K. S., White, A. L.,& Willians, M. (2009). Ethnic disparities in cervical cancer servival among texas women. Journal of Women’s Health, 18(10), 1577-1583.
Guzick, D. S. (1978). Efficacy of screening for cervical cancer: A review. American Journal of Public Health, 68, 125-134.
Hobbs, p. (1986). The behavioral aspects of breast and cervical screening. Radiography, 52(606), 287-290.
Hou, S. I. (2006). Perceived spousal support and beliefs toward cervical smear screening among Chinese women. Californian Journal of Health Promotion, 4(3), 157-164.
Hou, S. I., Fernandez, M. E., Baumler, E., Parcel, G. S., & Chen, P. H. (2003).Correlates of cervical cancer screening among women in Taiwan. Health Care for Women International, 24, 384-398.
Hsia, J., Kemper, E., & Kiefe, C. (2001). The importance of health insurance as a determinant of cancer screening: Evidence from the women’s health initiative. Preventive Medicine, 31(2), 61-70.
Islam, T., & Meade, N. (2000). Modelling diffusion and replacement. European Journal of Operational Research, 125, 551-570.
Jemal, A., Siegel, R., Ward, E., Hao, Y., Xu, J., & Thun, M. J. (2009). Cancer Statistics, 2009. CA:A Cancer Journal for Clinicians, 59(4), 225-249.
Kemp, R. (1998). The diffusion of biological waste-water treatment plants in the Dutch food and beverage industry. Environmental and Resource Economics, 12(1), 113-136.
Kemp, R., & Volpi, M. (2008). The diffusion of clean technologies: A review with suggestions for future diffusion analysis. Journal of Cleaner Production, 16, 14-21.
Kivistik, A., Lang, K., Baili, P., Anttila, A., & Veerus, P. (2011). Women’s knowledge about cervical cancer risk factors, screening, and reasons for nonparticipation in cervical cancer screening programme in Estonia. Bio Med Central Women’s Health, 11, Article 43.Retrieved March 2, 2012, from http://www.biomedcentral.com/1472-6874/11/43
Krogh, A., Larsson, B., von Heijne, G., & Sonnhammer, E. L. L. (2001). Predicting transmembrane protein topology with a hidden markov model: Application to complete genomes. Journal of Molecular Biology, 305(3), 567-580.
Koong, S. L., Yen, A. M. F., & Chen, T. H. H. (2006). Efficacy and cost-effectiveness of nationwide cervical cancer screening in Taiwan. Journal of Medical Screening, 13(1), S44-S47.
Larson, E. B., Bergam, J., & Rosenstock, I. M. (1982). Do postcard remailders improve influenza vaccination compliance? Medical Care, 20(6), 639-648.
Leavell, H. R., & Clark, E. G. (1965). Preventive medicine for the doctor in his community: An epidemiologic approach. New York: McGraw-Hill.
Lee, H. Y., Ju, E., Vang, P. D., & Lundquist, M. (2010). Breast and cervical cancer screening among Asian American women and Latinas: Does race / ethnicity matter? Journal of Women’s Health, 19(10),1877-1884.
Liao, C. C., Wang, H. Y., Lin, R. S., Hsieh, C. Y., & Sung, F. C. (2006). Addressing Taiwan’s high incidence of cervical cancer: Factors associated with the nation’s low compliance with papanicolaou screening in Taiwan. Public Health, 120, 1170-1176.
Lim, J. W. (2010). Linguistic and ethnic disparities in breast and cervical cancer screening and health risk behaviors among Latina and Asian American women. Journal of Women’s Health,19(6), 1097-1107.
Lin, Y. J., Chen, C. S., Liu, T. C., & Lin, H. C. (2008). Taiwan’s national health insurance system and the application of preventive care: The case of Pap smear testing. Public Health, 122, 857-861.
Mahajan, V., & Muller, E. (1996). Timing, diffusion and substitution of successive generations of technological innovations: The IBM mainframe case. Technological Forecasting and Social Change, 51, 109-132.
Madhavan, R., & Grover, R. (1998). From embedded knowledge to embodied knowledge: New product development as knowledge management. The Journal of Marketing, 62(4), 1-12.
Markovic, M., Kesic, V., Topic, L., & Matejic, B. (2005). Barriers to cervical cancer screening: A qualitative study with women in Serbia. Social Science & Medicine, 61(12), 2528-2535.
McMullin, J. M., De Alba, I., Chavez, L. R., & Hubbell, F. A. (2005). Influence of beliefs about cervical cancer etiology on Pap smear use among Latina immigrants. Ethnicity & Health, 10(1), 3-18.
Meyer, P. S., & Ausubel, J. H. (1999). Carrying capacity: A model with logistically varying limits. Technological Forecasting and Social Change, 70, 251-264.
Montalvo, C., & Kemp, R. (2008). Cleaner technology diffusion:Case studies, modeling and policy. Journal of Cleaner Production, 16 (S1), S1-S6.
Nishtar, S. (2007). Community health promotion– a step further. International Union for Health Promotion and Education, XIV(2). Retrieved March 2, 2012, from http://www.sanianishtar.info/pdfs/PromotEduc07.pdf
Rash, B., Martin-Hirsch, P., Schneider, A., Sideri, M., Tan, J., Torne, A., et al. (2008). Resource use and cost analysis of managing abnormal Pap smears: A retrospective study in five countries. European Journal of Gynaecological Oncology, 29(3), 225-232.
Redmond, W. H. (2004). Interconnectivity in diffusion of innovations and market competition. Journal of Business Research, 57, 1295-1302.
Rogers, E. M. (2003). Diffusion of innovations (5th ed.). New York, NY: Free Press.
Sadovsky, R. (1997). Identification of barriers to cervical cancer screening. American Family Physician, 56, 579-581.
Sohn, S. Y., & Ahn, B. J. (2003). Multigeneration diffusion model for economic assessment of new technology. Technological Forecasting and Social Change, 70, 251-264.
Tung, W. C., Lu, M., & Cook, D. (2010). Papanicolaou screening in Taiwan: Perceived barriers and self-efficacy. Health Care for Women International, 31, 421-434.
Varghese, C., Nongkynrih, B., Srinivasan, R., Sankaranarayanan,R., Basu, P., & Rajwanshi, A. (2008). Cervical cancer screening programme for low-resource settings: A pragmatic approach. Regional Health Forum, 12(2), 5-15.
Wang, P. D., & Lin, R. S. (1996). Sociodemographic factors of Pap smear screening in Taiwan. Public Health, 110, 123-127.
Wong, L. P., Wong, Y. L., Low, W. Y., Khoo, E. M., & Shuib, R. (2009). Knowledge and awareness of cervical cancer and screening among Malaysian women who have never had a Pap smear: A qualitative study. Singapore Medical Journal, 50(1), 49-53.
World Health Organization. (1978). International conference on primary health care, Alma-Ata. Retrieved February 1, 2012, from http://www.who.int/publications/almaata_declaration_en.pdf
World Health Organization. (1986). The Ottawa charter for health promotion. Retrieved February 1, 2012, from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.htmh
World Health Organization. (1997). Jakarta declaration on leading health promotion into the 21st century. Retrieved February 1, 2012, from http://www.who.int/healthpromotion/conferences/previous/jakarta/declaration/en
World Health Organization. (2005). New Bangkok charter for health promotion adopted to address rapidly changing global health issues. Retrieved February 1, 2012, from http://www.who.int/mediacentre/news/releases/2005/pr34/en/
Yang, T. C., Matthews, S. A., & Hillemerier, M. M. (2011). Effect of health care system distrust on breast and cervical cancer screening in Philadelphia, Pennsylvania. American Journal of Public Health, 101(7), 1297-1305.
Zahay, D. L., & Handfild, R. (2004). The role of learning in adoption of B2B technologies. Industrial Marketing Management, 33, 627-641.

QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top